Seneca ccbhc-IA initiative - the seneca ccbhc-IA initiative will provide comprehensive, coordinated behavioral health care for all people in need of behavioral health services at seneca's nicholas…

Seneca ccbhc-IA initiative - the seneca ccbhc-IA initiative will provide comprehensive, coordinated behavioral health care for all people in need of behavioral health services at seneca's nicholas county clinic which serves nicholas, pocahontas & webster counties in rural WV. The focus population suffers from SUD, poor mental health, low mental health workforce capacity, poor sdoh & poor disparity group outcomes. The initiative will serve 2,800 clients (700/year). Project goals (interventions/strategies) include: (1) increase access to & availability of community-based mental health/SUD TX and support for the focus population by enhancing SHS's ccbhc program by (a) hiring the ccbhc project director to lead the program & advisory board; (b) ensuring agency compliance with the ccbhc certification criteria; (c) collaborating with the state to obtain ccbhc certification; (d) maintaining existing & adding new service provider & community stakeholder partnerships; (e) conducting the needs assessment; (f) initiating, analyzing & addressing concerns identified via client satisfaction surveys; (g) advancing and monitoring agency training in response to the needs assessment; and (h) enhancing training via a focus on cultural competency & implicit bias training. (2) increase access to and availability of community-based mental health and substance use disorder treatment and support for the focus population by enhancing SHS's ccbhc services by (a) continuing to provide the 9 core ccbhc services; (b) enhancing crisis services by hiring 2 youth crisis specialists; (c) advancing physical health screening, assessment & diagnosis services; (d) improving treatment plan quality via training and EHR improvements; (e) expanding mental health services via hiring a therapist to initiate intensive outpatient programs; (f) expanding primary care services to the nicholas county clinic; (g) hiring two case managers; (h) expanding peer & family support services to include two mental health peers; (i) initiating a veteran's support group; and (j) developing and implementing a tobacco cessation program. (3) increase access to and availability of community-based mental health and SUD treatment and support for the focus population by improving SHS's ccbhc infrastructure by (a) facilitating care coordination by initiating medical EHR upgrades; (b) implementing health information exchange software to facilitate health information exchange; (c) initiating and maintaining care coordination agreements with identified partners; (d) supporting processes and procedures for collecting, reporting & tracking encounter, outcome, and quality data; (e) updating and implementing a ccbhc-wide data-driven CQI plan for clinical services & management; and (f) leveraging the patient portal to conduct measurement-based care. (4) support recovery from mental illness and or substance use disorders by providing access to high-quality mental health and substance use services to the target population by (a) ensuring that marketing products are culturally competent; (b) conducting community outreach & sdoh screening; (c) serving a total of 700 clients annually; (d) clients having a statistically significant decrease in illicit substance use at 6-month noms follow-up; (e) clients having a statistically significant decrease in tobacco use at 6-month noms follow-up; (f) having clients experience statistically significant improvement in noms mental health outcomes at 6-month; (g) clients having statistically significant improvement in social connectedness at 6-month follow-up; (h) having 80% of clients remain in treatment for at least 6-months throughout the life of the grant; and (i) monitoring disparity group data to ensure equal access/use/outcomes/retention. (5) sustain ccbhc services beyond grant funding to serve the focus population by (a) having the project director lead the ccbhc board which is made up of 51% people with lived experience; (b) creating a sustainability plan & (c) improving primary care billing